Summary
- Unlike non-cancerous symptoms, signs and symptoms of oral cancer tend to last more than 2 weeks or not heal.
- Common signs of oral cancer include sores that do not heal, discolored patches, trouble or pain when chewing, abnormal growths, inflammation, and unexplained, persistent bad breath.
- To prevent oral cancer, practice good oral hygiene, don’t use tobacco products, avoid excessive sun exposure, and consume alcohol in moderation or not at all.
- Talk to a doctor if oral symptoms last long, worsen, or spread.
Early Warning Signs of Oral Cancer
Oral cancer is a type of head and neck cancer that develops inside the mouth (oral cavity). It can form on the:
- Gums
- Lips
- Tongue
- Roof of the mouth
- Floor of the mouth beneath the tongue
- Inside of the cheeks
- First two-thirds of the tongue
- Region behind the wisdom teeth (back of the mouth behind the last teeth)
According to Dr. Nandita Lilly, one of NewMouth’s in-house dentists, “it is important to detect oral cancer in its early stages so the cancer can be treated more successfully.”
Oral cancer causes a wide range of signs and symptoms, depending on where it forms, including:
- Unexplained mouth, jaw, teeth, or ear pain
- Abnormal reddish, gray, or white patches on the mouth’s inner lining, gum, tonsils, or tongue
- Lumps, thickenings, or growths in the mouth or throat or on the lips
- Loose teeth
- Trouble or pain when swallowing
- Difficulty chewing
- Mouth or lip sores that don’t heal within 2 weeks or bleed easily
- Unexplained weight loss
- Persistent bad breath
- Voice or speech changes
- Jaw inflammation that makes dental devices like dentures painful or not fit well
- Unexplained numbness, odd sensations, or tenderness in the mouth, tongue, face, or neck
- A persistent sore throat or feeling like something is stuck in it
- Trouble or pain when moving the tongue or jaw
- Crusty or rough patches on the gums or lips or inside the mouth
- Sockets (holes in the gums where teeth are removed) that don’t heal
- Enlarged lymph nodes
How Do Dentists Diagnose Oral Cancer?
A dentist may spot signs of oral cancer during regular checkups. If this occurs, they will order preliminary tests and a biopsy to see if they are associated with oral cancer.
A dentist or other doctor may also refer you to an ear, nose, and throat (ENT) specialist, an oral maxiofacial surgeon or a dental oncologist to follow up on your symptoms.
To diagnose someone with oral cancer, an ENT specialist or dentist may perform a:
- Physical exam to look at or feel the inside of the mouth, around the mouth, head, face, or neck
- Brush biopsy or exfoliating cytology to remove a small sample from areas in question using a small brush or spatula
- Incisional biopsy to remove small bits of tissue for further examination
- Indirect pharyngoscopy or laryngoscopy to look at the base of the tongue, part of the voice box (larynx), or throat using a small mirror attached to a long, thin handle
- Direct (flexible) laryngoscopy or pharanygoscopy to look at parts of the mouth or throat with an endoscope (a flexible, thin tube with an attached lens and a light)
- Imaging tests such as CT, MRI, PET, or X-rays to see whether cancer has spread beyond the mouth
How Can You Prevent Oral Cancer?
There’s no scientifically established way to prevent oral cancer. But you may be able to reduce your risk of developing it by:
- Quitting or not starting smoking or using tobacco products
- Drinking alcohol in moderation (or not at all)
- Getting a routine dental exam twice a year
- Avoiding excessive sun exposure to the lips (and applying UV-AB blocking sunscreen to the face and lips)
- Getting the HPV vaccine and avoiding intimate contact or sharing personal items with people who have the human papillomavirus (HPV)
- Undergoing oral cancer screening every 6 months during your dental check-ups
- Maintaining a healthy, well-balanced diet
4 Types of Oral Cancer and Their Symptoms
Cancer can impact anywhere in the mouth. But some types of oral cancer are more common than others. Some of the more common types of mouth cancer include:
1. Cheek cancer
Cheek cancer impacts the inner lining of the cheek. People who use tobacco products or drink alcohol are more likely to develop cheek cancer.
Symptoms
Common symptoms associated with cheek cancer include:
- White, gray, or red patches or lumps on the inside of the cheeks
- Pain or numbness
- Trouble moving the jaw or jaw inflammation
- Severe pain in the ear
- Hoarseness or feeling like something is stuck in the throat
Treatment
Most people with cheek cancer undergo surgery. More advanced cases may also require radiation or chemotherapy.
2. Floor of the mouth cancer
Floor of the mouth cancer impacts the flat, thin cells that line the bottom of the mouth. It’s unclear what causes floor of the mouth cancer. But some factors increase the risk of developing it, such as:
- Using tobacco products
- Drinking alcohol in excess
- Having the human papillomavirus (HPV)
- Taking medications that impact the immune system
- Chronic trauma from ill-fitting dentures, faulty restorations
Symptoms
A sore or lump that won’t heal is often the first sign of floor of the mouth cancer. Other symptoms include:
- Mouth or ear pain
- Pain when swallowing
- Unexplained weight loss
- Painful swelling in the neck
- Loose teeth
- White, gray, or red patches that don’t go away
Treatment
Most people with floor of the mouth cancer undergo surgery, radiation therapy, and chemotherapy. They may also undergo reconstructive surgery so they can eat, drink, and talk properly.
3. Gum Cancer
Gum cancer is cancer that develops in the upper or lower gums. It is often mistaken for less serious conditions, like gingivitis.
The true cause of gum cancer is unknown. But drinking alcohol and using tobacco products seems to increase the likelihood of developing it.
Symptoms
Common symptoms of gum cancer include:
- Cracking or bleeding gums
- Thickened parts of the gums
- Red or white patches on the gums
Treatment
Most people with gum cancer undergo surgery. More advanced cases may also require chemotherapy or radiation therapy.
4. Lip Cancer
Lip cancer impacts the skin of the lips.
It’s unknown what causes lip cancer. However, tobacco products and excessive sun exposure increase the risk of developing it. People with pale skin or weakened immune systems are also more likely to develop lip cancer.
Symptoms
Common symptoms and signs associated with lip cancer include:
- Lip sores that don’t heal
- Pain, numbness, or tingling on the lips or skin surrounding the mouth
- Slightly raised or flat whitish colored areas of the lip
Treatment
Most people with lip cancer undergo surgery to remove the cancerous area and parts of the surrounding area. A surgeon may also repair the region to reduce scarring and make it easier to eat, drink, and speak.
Other treatments for lip cancer include:
- Radiation or chemotherapy
- Targeted drug therapy
- Immunotherapy
5. Tongue Cancer
Tongue cancer can impact the first two-thirds of the tongue (oral tongue) or the back one-third (base).
People who smoke are five times more likely to develop tongue cancer than non-smokers. Having HPV, particularly HPV-16 and HPV-18, also increases the risk of developing tongue cancer.
Symptoms
Tongue cancer can cause different symptoms, depending on the part of the tongue it impacts.
Symptoms of oral tongue cancer include a lump that:
- Is on the side of the tongue that contacts the teeth
- Looks like a sore that is red to grayish-pink
- Bleeds easily when touched or bitten
Symptoms of cancer on the base of the tongue are usually unnoticeable in the early stages. But in later stages, it may cause:
- Pain in the tongue
- A sensation that feels like the throat is full
- Trouble swallowing
- Ear pain
- Voice changes
- Feeling of a lump in the throat or neck
Treatment
The best treatment for tongue cancer depends on the stage of cancer. But most people undergo surgery, radiation therapy, and chemotherapy.
6. Jaw Cancer
Cancer of the jaw often develops when cancers elsewhere in the mouth spread (metastasize).
Jaw cancer tends to occur due to genetic and environmental factors. Risk factors include:
- Smoking or chewing tobacco
- Alcohol consumption
- Chewing betel nuts
- Being overweight
- Age (being 55 or older)
- Family history of jaw cancer
- Poor nutrition
- Poor oral hygiene
- Viral infections like HPV (in people under the age of 50)
Symptoms
The early stages of jaw cancer may not cause any obvious symptoms.
But jaw cancer can cause:
- Bad breath
- Pain or trouble swallowing
- Painful sores that don’t heal
- White or red patches that last for weeks
- Recurrent bleeding
- Swelling
- Numbness in the tongue or mouth
- Ear or jaw pain
- Trouble speaking
- Loose teeth
- Dentures that no longer fit properly
Treatment
The type of treatment for jaw cancer depends on the stage and extent of cancer. But it is often treated using surgery, chemotherapy, and radiation therapy.
Rare Types of Oral Cancer
Oral cancers often involve the lips, tongue, or jaw.
Less common types of oral cancer include:
1. Verrucous Carcinoma
Verrucous carcinoma is a very slow-growing cancer that tends to cause mouth sores.
2. Salivary Gland Carcinomas
This type of cancer affects the glands that produce saliva. Symptoms include:
- Pain or swelling/lumps in the cheek, neck, jaw, or mouth
- Numbness
- Trouble opening the mouth wide or swallowing
- Weakness in one side of the face
3. Lymphoma
Lymphoma develops in part of the immune system called lymph tissues or glands. The base of the tongue and tonsils contain lymph tissues. Symptoms include:
- Swollen lymph nodes
- Unexplained exhaustion or weight loss
- Night sweats
